A tortured choice in famine: Which child lives? (AP)

By MALKHADIR M. MUHUMED, Associated Press Malkhadir M. Muhumed, Associated Press – 33?mins?ago

DADAAB, Kenya – Wardo Mohamud Yusuf walked for two weeks with her 1-year-old daughter on her back and her 4-year-old son at her side to flee Somalia's drought and famine. When the boy collapsed near the end of the journey, she poured some of the little water she had on his head to cool him, but he was unconscious and could not drink.

She asked other families traveling with them for help, but none stopped, fearful for their own survival.

Then the 29-year-old mother had to make a choice that no parent should have to make.

"Finally, I decided to leave him behind to his God on the road," Yusuf said days later in an interview at a teeming refugee camp in Dadaab, Kenya. "I am sure that he was alive, and that is my heartbreak."

Parents fleeing the devastating famine on foot — sometimes with as many as seven children in tow — are having to make unimaginably cruel choices: Which children have the best chance to survive when food and water run low? Who should be left behind?

"I have never faced such a dilemma in my life," Yusuf told The Associated Press. "Now I'm reliving the pain of abandoning my child. I wake up at night to think about him. I feel terrified whenever I see a son of his age."

Dr. John Kivelenge, a mental health officer for the International Rescue Committee at Dadaab emphasizes the extreme duress Somali mothers and fathers are facing.

"It is a normal reaction to an abnormal situation. They can't sit down and wait to die together," he said. "But after a month, they will suffer post-traumatic stress disorder, which means they will have flashbacks and nightmares.

"The picture of the children they abandoned behind will come back to them and haunt them," he said. "They will also have poor sleep and social problems."

The United States estimates that more than 29,000 Somali children under age 5 have died in the famine in the last three months. An unknown number too weak to walk farther have been abandoned on the sandy trek to help after food and water supplies ran out.

Faduma Sakow Abdullahi, a 29-year-old widow, attempted the journey to Dadaab with her baby and other children ages 5, 4, 3 and 2. A day before she reached the refugee camp, her 4-year-old daughter and 5-year-old son wouldn't wake up after a brief rest.

Abdullahi said she did not want to "waste" the little water she had in a 5-liter container on dying children when the little ones needed it.

Nor did she want to wait for too long until her other children started dying, so she stood up and walked away a few paces — then returned in the hopes the youngsters were in fact alive.

After several back-and-forth walks, she finally left her two children under a tree, unsure whether they could be resuscitated.

More than 12 million people in East Africa are in need of food aid because of the severe drought. The U.N. says 2.8 million of those are in need of immediate lifesaving assistance, including more than 450,000 in Somalia's famine zones.

Ahmed Jafar Nur, a 50-year-old father of seven, was traveling with his 14-year-old son and 13-year-old daughter to Kenya. But after only two days of walking, they ran out of water. By the third day, they could only sit beneath a big tree — thirsty, hungry and exhausted.

"The two children could not walk on anymore. Then instead of us all dying there, I was forced to leave them to their fate, especially after I thought of the other five children and their mother I left behind at home. I said to myself, 'Save your life for the interest of the five others. These two have their God,'" he said.

"That was the worst thing I experienced in my life. It was a heartbreaking experience to abandon my children who are part of myself," he said. "For almost three months, my mind was not stable. Their images were in front of me."

Miraculously, the two teenagers were saved by nomads, and they have since made their way back to their mother in Somalia. But Nur said he can't afford to bring the rest of his family to Kenya because it cost too much.

"I was a farmer and had no education that can help me now get jobs. We depend on handouts," he said. "My mind is preoccupied with them: Will they all die, including their mother, or will some survive? That is what I always ask myself."

When Faqid Nur Elmi's 3-year-old son died of hunger and thirst on the road from Somalia, his mother could only surround his body with small dried branches to serve as a grave. She couldn't stop to mourn — there were five other children to think about.

"Where will I get the energy to dig up a grave for him?" she asked. "I was just thinking of how I can save the rest of the children. The God who gave me him in the first place took him away. So I didn't worry much about the late son. Others' lives were at risk."

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US: 29,000 Somali children under 5 dead in famine (AP)

NAIROBI, Kenya – The drought and famine in Somalia have killed more than 29,000 children under the age of 5, according to U.S. estimates, the first time such a precise death toll has been released related to the Horn of Africa crisis.

The United Nations has said previously that tens of thousands of people have died in the drought, the worst in Somalia in 60 years. The U.N. says 640,000 Somali children are acutely malnourished, a statistic that suggests the death toll of small children will rise.

Nancy Lindborg, an official with the U.S. government aid arm, told a congressional committee in Washington on Wednesday that the U.S. estimates that more than 29,000 children under the age of 5 have died in the last 90 days in southern Somalia. That number is based on nutrition and mortality surveys verified by the U.S. Centers for Disease Control and Prevention.

The U.N. on Wednesday declared three new regions in Somalia famine zones, bringing the total number to five. Out of a population of roughly 7.5 million, the U.N. says 3.2 million Somalis are in need of immediate lifesaving assistance.

Getting aid to Somalia has been made more difficult because al-Qaida-linked militants control much of the country's most desperate areas. Al-Shabab has denied that a famine is taking place, and won't give access to the World Food Program, the world's biggest provider of food aid.

Tens of thousands of refugees have fled south-central Somalia in hopes of finding food at camps in Ethiopia, Kenya and in Mogadishu, the Somali capital.

Hundreds of millions of dollars have been donated to fight the hunger crisis, but the U.N. says it needs hundreds of millions more.

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UN declares famine in southern Somalia (AFP)

NAIROBI (AFP) – The UN officially declared famine on Wednesday in two southern Somalia regions, as the world slowly mobilised to save the 12 million people battling hunger in the region's worst drought in 60 years.

The United States urged the Al Qaeda-inspired rebels controlling the area to allow the return of the relief groups they expelled two years ago while aid groups warned many would die without urgent action and funding.

UN Humanitarian Affairs Coordination for Somalia Mark Bowden declared that southern Bakool and Lower Shabelle regions had been hit by famine.

The UN said that an estimated 3.7 million people -- nearly half of the war-torn country's population -- were facing a food crisis.

"If we don't act now, famine will spread to all eight regions of southern Somalia within two months, due to poor harvests and infectious disease outbreaks," Bowden told reporters.

"If we are not able to intervene immediately, tens of thousands more Somalis may die," the UN added.

Somalia, which has been affected by almost uninterrupted conflict for 20 years and become a by-word for "failed state", is the worst affected nation but parts of Kenya, Uganda, Ethiopia and Djibouti are also hit.

The United States urged neighbouring Eritrea, one of the most secretive countries in the world, to reveal the scope of its own food situation.

"Given the combination of severity and geographic scope this is the most severe food security crisis in Africa since the 1991/2 Somalia famine," the UN added.

Famine implies that at least 20 percent of households face extreme food shortages, acute malnutrition in over 30 percent of people, and two deaths per 10,000 people every day, according to UN definition.

The Shebab expelled foreign aid groups two years ago, accusing them of being Western spies and Christian crusaders.

However, the UN last week airlifted in the first supplies since the group said it would lift restrictions on aid.

Malnutrition rates in Somalia are currently the highest in the world, with peaks of 50 percent in certain areas of southern Somalia, Bowden said.

"Every day of delay in assistance is literally a matter of life or death for children and their families in the famine affected areas," Bowden said.

Over 78,000 Somalis have fled to seek refuge in neighbouring Ethiopia and Kenya in the last two months.

In Kenya, they are streaming into overcrowded camps hosting some 380,000 people -- more than four times the original capacity.

On Tuesday, the UN refugee agency said death rates among refugees arriving in Ethiopia's Dolo Ado area reached 7.4 per 10,000 in June, 15 times more than the baseline rate in sub-Sahara Africa.

Somalia's embattled government welcomed the famine declaration -- the first since the term was defined by the UN in 2008 -- as a sign that the world was beginning to acknowledge the scope of the disaster.

"At least it is great that the world has recognised the magnitude of hardship the poor Somalis are facing," Abdulkadir Moalim Nur, a minister in the president's office, told AFP.

The Food and Agricultural Organisation appealed Wednesday for $120 million (84 million euros) for the 12 million drought victims in the Horn of Africa.

Aid group Oxfam said only $200 million (140 million euros) of the needed one billion (700 million euros) had been provided.

"There is no time to waste if we are to avoid massive loss of life. We must not stand by and watch this tragedy unfold before our eyes," said Fran Equiza, Oxfam's Regional Director.

The government's authority over the vast country is limited and Johnnie Carson, the US assistant secretary of state for African affairs, stressed that the Shebab's responsibility in the suffering was clear.

A top Shebab official welcomed the UN's famine declaration, saying they would allow aid through.

"The declaration of famine in parts of Somalia by the UN is welcome and we would like to see aid coming to the people," a senior Shebab official told AFP on condition of anonymity.

"Aid must be provided purely on a humanitarian basis, and the religious value of Somalis as Muslims must be respected," the official added.

UN agencies will hold a meeting Monday in Rome over the drought-sparked humanitarian crisis as the world's top leaders called for mass mobilisation to contain one of the planet's worst unfolding humanitarian disasters.

In a statement released during a visit to India, US Secretary of State Hillary Clinton pledged more funds to tackle the crisis and called for the international community to follow suit.

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Somalis dying in world's worst famine in 20 years (AP)

NAIROBI, Kenya – Tens of thousands of Somalis are feared dead in the world's worst famine in a generation, the U.N. said Wednesday, and the U.S. said it will allow emergency funds to be spent in areas controlled by al-Qaida-linked militants as long as the fighters do not interfere with aid distributions.

Exhausted, rail-thin women are stumbling into refugee camps in Kenya and Ethiopia with dead babies and bleeding feet, having left weaker family members behind along the way.

"Somalia is facing its worst food security crisis in the last 20 years," said Mark Bowden, the U.N.'s top official in charge of humanitarian aid in Somalia. "This desperate situation requires urgent action to save lives ... it's likely that conditions will deteriorate further in six months."

The crisis is the worst since 1991-92, when hundreds of thousands of Somalis starved to death, Bowden said. That famine prompted intervention by an international peacekeeping force, but it eventually pulled out after two American Black Hawk helicopters were shot down in 1993.

Since then, Western nations have mainly sought to contain the threat of terrorism from Somalia — an anarchic nation where the weak government battles Islamic militants on land and pirates hijack ships for millions of dollars at sea.

Oxfam said $1 billion is needed for famine relief. On Wednesday, the U.S. announced an additional $28 million in emergency funding on top of the $431 million in assistance already given this year.

Most importantly, as long as the Islamists don't interfere with aid distributions, those new U.S. funds aren't restricted under rules implemented in 2009 that are designed to keep food and money from being stolen by the insurgency.

"If (the insurgents) are willing to allow access we are willing to stand fully with the humanitarian actors," said Dr. Raj Shah, head of the U.S. Agency for International Development.

Aid groups have repeatedly called for the restrictions to be lifted and say the rules severely limited their operations in the past two years. U.S. humanitarian contributions in Somalia fell from $237 million in 2008 to $29 million last year.

"We've seen a very large shortfall over the past few years given the political restrictions attached to humanitarian funding," said Tanja Schumer of the Somalia NGO Consortium, which represents 78 aid agencies working on Somalia. "To get American money we have to vouch for all our contractors and all our local partners and that is tricky."

Susan Rice, the U.S. ambassador to the United Nations, blamed al-Shabab for exacerbating the crisis.

"The reason the aid hasn't gone in sufficient quantities into south and central Somalia is because al-Shabab has prevented those capable of delivering large quantities of aid from having access — and when they have had access they've taxed them, harassed them, killed them, kidnapped them," Rice told reporters at U.N. headquarters in New York.

Somalia is the most dangerous country in the world to work in, according to the U.N.'s World Food Program, which has lost 14 relief workers in the past few years. Kidnappings, killings and attacks on aid convoys occur frequently. Two years ago WFP pulled out of Islamist-controlled southern Somalia after the rebels demanded cash payments and other concessions.

U.S. military operations against terrorism suspects also have disrupted humanitarian operations, said Bowden. Insurgents vowed to target foreign aid workers after a U.S. missile strike killed the head of the Islamist al-Shabab militia and 24 other people in 2008. Aden Hashi Ayro was reputedly al-Qaida's commander in Somalia and linked to a string of attacks on foreign aid workers and journalists.

But WFP head Josette Sheeran said the agency is willing to return to southern Somalia if the insurgents guarantee safe passage and free access to aid. Two regions of Somalia — Bakool and Lower Shabelle — are suffering from famine and eight more are at risk.

"We are absolutely fully committed to going where the hungry are," she said.

The Horn of Africa is suffering a devastating drought compounded by war, neglect, poor land policies and spiraling prices. Some areas in the region have not had such a low rainfall in 60 years, aid group Oxfam said. Kenya, Ethiopia and Djibouti have all been badly affected, and Eritrea is also believed to be suffering, although its repressive government does not release figures.

Yet only parts of Somalia are technically suffering from famine, defined as when two adults or four children per 10,000 people die of hunger each day and a third of children are acutely malnourished.

In some areas of Somalia, six people are dying a day and more than half of children are acutely malnourished, Bowden said. Prices of staple foods have increased 270 percent over the last year, compounding the misery.

Somalia's civil war is partly to blame, said Joakim Gundel, who heads Katuni Consult, a Nairobi-based company often asked to evaluate international aid efforts in Somalia.

He said aid groups found fundraising easier if they blamed natural disaster rather admitting the emergency was partly caused by a complex, 20-year civil war worsened by international apathy and incompetence.

"There is no clear cut answer," he said. "People are suffering and there is a need to respond. But drought is not the only cause. Conflict is a key reason and it is not being addressed properly."

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Associated Press writer Edith M. Lederer at the United Nations contributed to this report.

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